Women & Autoimmune Health: Hormonal Shifts Through Life Stages
by Dr. Anindita Santosa
Autoimmune diseases affect women far more often than men. In fact, nearly 80% of autoimmune conditions occur in women, often appearing during key life stages marked by hormonal change. These shifts — puberty, pregnancy, postpartum, perimenopause, and menopause — can influence not only how symptoms present, but also how active or unpredictable a disease may feel.
At Aaria Rheumatology in Singapore, we believe that understanding these connections empowers women to make informed decisions and navigate their health with confidence.
Puberty: First Signals
Puberty brings rapid surges of estrogen and progesterone, which can alter immune system activity. For some girls, this is the time when autoimmune conditions such as lupus, juvenile idiopathic arthritis, or autoimmune thyroid disease first appear.
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Encourage open conversations about symptoms like persistent fatigue, joint pain, or unexplained rashes.
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Early specialist check-ups allow timely diagnosis and better outcomes.
Pregnancy: Immune Adaptation in Motion
Pregnancy is unique: the immune system adapts to protect the growing baby. Some women experience improvement in autoimmune symptoms, while others notice new challenges.
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Pre-pregnancy planning with a rheumatologist is essential, as some medications need to be adjusted before conception.
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Postpartum flares are common — early follow-up helps ensure both mother and baby are supported.
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Close collaboration between rheumatology, obstetrics, and pediatrics provides safer outcomes.
Postpartum: Navigating Rapid Change
The postpartum period is marked by steep hormonal drops, sleep disruption, and physical recovery. For women with autoimmune disease, this stage can be one of the highest-risk periods for flares.
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Seek practical support with caregiving and rest.
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Schedule an early postpartum review with your rheumatologist.
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Mental health support is vital — depression and anxiety are more common when living with both autoimmune disease and new motherhood.
Perimenopause & Menopause: Long-Term Shifts
During perimenopause, fluctuating hormones may trigger changes in flare frequency or symptom patterns. Once menopause occurs, estrogen levels remain low, impacting both immune and body systems.
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Autoimmune symptoms may shift; tracking patterns helps guide treatment.
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Bone health and cardiovascular health become key priorities. Women with autoimmune diseases already have a higher risk of osteoporosis and heart disease.
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Protective measures: weight-bearing exercise, calcium-rich diets, vitamin D, and regular bone density scans.
Mental & Emotional Wellbeing Across Stages
Hormonal and autoimmune changes affect not just the body but also the mind.
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Counselling, mindfulness, and peer support help women feel less isolated.
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Holistic care means acknowledging fatigue, mood shifts, and the invisible burden of living with a chronic condition.
Empowering Women Through Care
Every stage of life brings new questions — and opportunities for proactive care. Building a support network of healthcare teams, family, and community resources empowers women to approach these transitions with resilience.
At Aaria Rheumatology, we provide personalised, holistic care to support women’s autoimmune health across all stages of life.
Disclaimer:
The information shared in this article is for general educational and informational purposes only. It should not be taken as medical advice, diagnosis, or treatment. Readers should not rely solely on this content for managing health conditions. Always consult a qualified healthcare professional for personalized medical guidance. The views expressed here are my own and do not necessarily represent those of any institution or organization I am affiliated with.
About the Author
Dr. Anindita Santosa is a Rheumatologist, Allergist, and Clinical Immunologist based in Singapore. She is Medical Director of Aaria Rheumatology, Deputy Chairman of the National Arthritis Foundation, and co-founder of healthtech ventures AIGP Health and Clinversa. Passionate about health equity and women’s health, she works at the intersection of clinical care, research, and technology to make specialty medicine more accessible.
